Pub Date : 2023-01-01DOI: 10.4103/ecdt.ecdt_133_22
Hend Ismael, Abdellah Hamed, Shimaa Nour
Abstract Background Patients with stable chronic obstructive pulmonary disease (COPD) are more likely to have cardiac abnormalities, which increase morbidity and mortality. The aim of the study is to explore correlations and probable predictors for these abnormalities in stable COPD patients. Patients and methods We conducted a prospective cohort study including 91 stable COPD cases, who were admitted to a tertiary health-care center during the period from August 2021 to January 2022. Spirometry, arterial blood gas, and ECG were performed for all participants. They were categorized using GOLD guidelines (2021) and assessed by two-dimensional Doppler echocardiography using the American and European Association of Echocardiography ASE recommendations. Results The study included 91 COPD patients; their mean age was 60.5 years with male predominance (62.6%). Of the patients, 76.9% were smokers and 49.5% of patients have respiratory failure type II. The most common abnormal ECG findings were P pulmonale, ventricular ectopic, and ischemic changes, which were more detected in severe COPD patients (94.29%). Echocardiographic assessment showed abnormal findings in almost 65%, more in the severe group. The most frequent findings were signs of pulmonary hypertension (PH) (72.5%), right ventricular dilatation (49.5%), and hypokinesia (21.98%). Risk factors of cardiac abnormalities were respiratory failure, COPD duration, comorbidities, and COPD stage. Conclusion Right ventricle dilatation, hypokinesia, and PH showed a positive correlation with echocardiographic findings and COPD severity. Respiratory failure and COPD duration were independent predictors of arrhythmia; COPD stage and the number of comorbidities were predictors of cardiac ischemia, while respiratory failure and comorbidities were predictors of PH.
{"title":"Cardiac abnormalities in stable chronic obstructive pulmonary disease: correlations and predictors","authors":"Hend Ismael, Abdellah Hamed, Shimaa Nour","doi":"10.4103/ecdt.ecdt_133_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_133_22","url":null,"abstract":"Abstract Background Patients with stable chronic obstructive pulmonary disease (COPD) are more likely to have cardiac abnormalities, which increase morbidity and mortality. The aim of the study is to explore correlations and probable predictors for these abnormalities in stable COPD patients. Patients and methods We conducted a prospective cohort study including 91 stable COPD cases, who were admitted to a tertiary health-care center during the period from August 2021 to January 2022. Spirometry, arterial blood gas, and ECG were performed for all participants. They were categorized using GOLD guidelines (2021) and assessed by two-dimensional Doppler echocardiography using the American and European Association of Echocardiography ASE recommendations. Results The study included 91 COPD patients; their mean age was 60.5 years with male predominance (62.6%). Of the patients, 76.9% were smokers and 49.5% of patients have respiratory failure type II. The most common abnormal ECG findings were P pulmonale, ventricular ectopic, and ischemic changes, which were more detected in severe COPD patients (94.29%). Echocardiographic assessment showed abnormal findings in almost 65%, more in the severe group. The most frequent findings were signs of pulmonary hypertension (PH) (72.5%), right ventricular dilatation (49.5%), and hypokinesia (21.98%). Risk factors of cardiac abnormalities were respiratory failure, COPD duration, comorbidities, and COPD stage. Conclusion Right ventricle dilatation, hypokinesia, and PH showed a positive correlation with echocardiographic findings and COPD severity. Respiratory failure and COPD duration were independent predictors of arrhythmia; COPD stage and the number of comorbidities were predictors of cardiac ischemia, while respiratory failure and comorbidities were predictors of PH.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135667822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/ecdt.ecdt_128_22
Samar B Younis, Mona M Ahmed, Marwa S Daif
Abstract Background and purpose The WHO declared the coronavirus disease 2019 (COVID-19) outbreak a global public health emergency on January 30, 2020, and the word ‘pandemic’ was first used to describe the disease’s global spread in March of that year. Chronic lung disease (19.2% was the most common co-occurring condition with COVID-19), at 20.8%, followed by chronic kidney disease (20.8%), and then cardiovascular disease (60.9%). This research aimed to assess the prognosis of COVID-19-confirmed cases receiving isolation care at Hurghada General Hospital. Study design An observational study that was retrospective and cross-sectional. Setting Isolation department in Hurghada General Hospital. Patients We included 122 patients with COVID-19 infection, and classified them into two independent groups: the improvement group (93 patients), and the morbidity (complication) and mortality group (29 patients). Methods Clinical data (COVID-19 symptoms and vital signs), laboratory data (complete blood count, C-reactive protein, ferritin level in the blood, hepatic and renal functions tests, coagulation profile, and level of D-dimer), radiological data (computed tomography of the chest), and drug and antibiotic data were collected from all patients. The following parameters were assessed in each patient: length of hospital stay, ICU admission, mechanical ventilation, morbidity (complication), mortality, improvement, and discharge. Results Patients’ average age in the sample was 55 ± 16.3 years. Regarding patients’ respective sexes, 55.7% of patients were females, while 44.3% were males. Regarding the final outcome data, the average length of hospital stay was 9.2 ± 6.2 days, with 33.6% of patients having ICU admission, 9% were ventilated, morbidity(16.4%) (complication) (4.9% psychological and neurological disorders, 3.3% post-COVID oxygen-dependent therapy, 8.2% renal impairment), and mortality (7.4%), while 76.2% had improved and discharged. Logistic regression results demonstrated that the increase in age, BMI, lactate dehydrogenase, D-dimer, computed tomography chest affection, and COVID-19 severity (according to clinical, laboratory and radiological data); added to the risk of needing to be admitted to a hospital’s ICU on its own ( P <0.05, respectively). Decreases in oxygen saturation, urea, and prothrombin time were found to independently increase the likelihood of ICU admission in a logistic regression analysis ( P <0.05). Conclusion We conclude that age and comorbidities such as diabetes, hypertension, ischemic heart disease, and lung fibrosis are strongly related to adverse outcomes in COVID-19 patients admitted to the Hurghada Isolation Hospital. It was also more likely that those patients would develop acute respiratory distress syndrome or severe pneumonia. Strict treatment protocol and isolation lead to better outcomes.
{"title":"Study of COVID-19 confirmed cases in isolation hospital in (Hurghada General Hospital)","authors":"Samar B Younis, Mona M Ahmed, Marwa S Daif","doi":"10.4103/ecdt.ecdt_128_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_128_22","url":null,"abstract":"Abstract Background and purpose The WHO declared the coronavirus disease 2019 (COVID-19) outbreak a global public health emergency on January 30, 2020, and the word ‘pandemic’ was first used to describe the disease’s global spread in March of that year. Chronic lung disease (19.2% was the most common co-occurring condition with COVID-19), at 20.8%, followed by chronic kidney disease (20.8%), and then cardiovascular disease (60.9%). This research aimed to assess the prognosis of COVID-19-confirmed cases receiving isolation care at Hurghada General Hospital. Study design An observational study that was retrospective and cross-sectional. Setting Isolation department in Hurghada General Hospital. Patients We included 122 patients with COVID-19 infection, and classified them into two independent groups: the improvement group (93 patients), and the morbidity (complication) and mortality group (29 patients). Methods Clinical data (COVID-19 symptoms and vital signs), laboratory data (complete blood count, C-reactive protein, ferritin level in the blood, hepatic and renal functions tests, coagulation profile, and level of D-dimer), radiological data (computed tomography of the chest), and drug and antibiotic data were collected from all patients. The following parameters were assessed in each patient: length of hospital stay, ICU admission, mechanical ventilation, morbidity (complication), mortality, improvement, and discharge. Results Patients’ average age in the sample was 55 ± 16.3 years. Regarding patients’ respective sexes, 55.7% of patients were females, while 44.3% were males. Regarding the final outcome data, the average length of hospital stay was 9.2 ± 6.2 days, with 33.6% of patients having ICU admission, 9% were ventilated, morbidity(16.4%) (complication) (4.9% psychological and neurological disorders, 3.3% post-COVID oxygen-dependent therapy, 8.2% renal impairment), and mortality (7.4%), while 76.2% had improved and discharged. Logistic regression results demonstrated that the increase in age, BMI, lactate dehydrogenase, D-dimer, computed tomography chest affection, and COVID-19 severity (according to clinical, laboratory and radiological data); added to the risk of needing to be admitted to a hospital’s ICU on its own ( P <0.05, respectively). Decreases in oxygen saturation, urea, and prothrombin time were found to independently increase the likelihood of ICU admission in a logistic regression analysis ( P <0.05). Conclusion We conclude that age and comorbidities such as diabetes, hypertension, ischemic heart disease, and lung fibrosis are strongly related to adverse outcomes in COVID-19 patients admitted to the Hurghada Isolation Hospital. It was also more likely that those patients would develop acute respiratory distress syndrome or severe pneumonia. Strict treatment protocol and isolation lead to better outcomes.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135667836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Context Fluvoxamine may have a potential immune-regulatory action and a therapeutic role in severe acute respiratory syndrome-coronavirus (SARS-CoV-2) infection that may prevent progression and/or hospitalization. Aims Trial that compared fluvoxamine versus placebo in nonhospitalized adults with confirmed SARS-CoV-2 infection (mild and moderate coronavirus disease 2019 cases). Settings and design This is a double-blinded, randomized clinical trial. Patients and methods The study enrolled 162 cases with positive PCR assay for SARS-CoV-2 infection and who were symptomatic within 7 days of the first dose of study medication. Statistical analysis The demographic, clinical, and laboratory data gathered together will be tabulated and statistically analyzed. The statistical analysis of data was carried out using Excel and the SPSS programs statistical package for AQ8 Social Sciences, version 17. Quantitative data were described as median (minimum–maximum). An analysis of the data was carried out to test statistically significant differences between groups. Quantitative data were presented as mean±SD and the Student’s t test was used to compare between two groups. Results In all, 162 patients completed the study; 72 patients were of mild severity; 90 patients were moderate cases and each group was randomized to receive fluvoxamine or placebo besides standard care. In the mild group, no significant difference was recorded while slight significance exists in the moderate severity group. Conclusions Fluvoxamine may have an added value besides the current standard care in reducing the need for hospitalization in outpatient cases, especially pneumonic ones; however, more larger studies are needed.
氟伏沙明可能在严重急性呼吸综合征-冠状病毒(SARS-CoV-2)感染中具有潜在的免疫调节作用和治疗作用，可预防进展和/或住院。目的比较氟伏沙明和安慰剂在确诊SARS-CoV-2感染的未住院成人(2019年轻中度冠状病毒病病例)中的作用。这是一项双盲随机临床试验。患者与方法本研究纳入162例PCR检测阳性的SARS-CoV-2感染病例，并在首次给药后7天内出现症状。统计分析收集到的人口统计、临床和实验室数据将被制成表格并进行统计分析。数据的统计分析使用Excel和SPSS程序statistical package for AQ8 Social Sciences, version 17进行。定量数据用中位数(最小-最大)描述。对数据进行了分析，以检验组间的统计学显著差异。定量数据以mean±SD表示，两组间比较采用Student’s t检验。结果共162例患者完成研究;轻度72例;中度病例90例，每组在标准治疗的基础上随机接受氟伏沙明或安慰剂治疗。轻度组无显著性差异，中度组有轻微显著性差异。结论氟伏沙明在减少门诊病人特别是肺炎病人住院治疗方面有一定的附加价值;然而，还需要更大规模的研究。
{"title":"Treatment with fluvoxamine in nonhospitalized coronavirus disease 2019 patients","authors":"M. Ibrahim, Mohammed Shehta","doi":"10.4103/ecdt.ecdt_38_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_38_22","url":null,"abstract":"Context Fluvoxamine may have a potential immune-regulatory action and a therapeutic role in severe acute respiratory syndrome-coronavirus (SARS-CoV-2) infection that may prevent progression and/or hospitalization. Aims Trial that compared fluvoxamine versus placebo in nonhospitalized adults with confirmed SARS-CoV-2 infection (mild and moderate coronavirus disease 2019 cases). Settings and design This is a double-blinded, randomized clinical trial. Patients and methods The study enrolled 162 cases with positive PCR assay for SARS-CoV-2 infection and who were symptomatic within 7 days of the first dose of study medication. Statistical analysis The demographic, clinical, and laboratory data gathered together will be tabulated and statistically analyzed. The statistical analysis of data was carried out using Excel and the SPSS programs statistical package for AQ8 Social Sciences, version 17. Quantitative data were described as median (minimum–maximum). An analysis of the data was carried out to test statistically significant differences between groups. Quantitative data were presented as mean±SD and the Student’s t test was used to compare between two groups. Results In all, 162 patients completed the study; 72 patients were of mild severity; 90 patients were moderate cases and each group was randomized to receive fluvoxamine or placebo besides standard care. In the mild group, no significant difference was recorded while slight significance exists in the moderate severity group. Conclusions Fluvoxamine may have an added value besides the current standard care in reducing the need for hospitalization in outpatient cases, especially pneumonic ones; however, more larger studies are needed.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"28 1","pages":"40 - 45"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89610927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Zamzam, Rabab A. El-Wahsh, A. El-Abedin, Hend Bedir, Asmaa Abdel Tawab
Aim To evaluate the prevalence of anxiety and depression in patients with obstructive sleep apnea (OSA) and effect of continuous positive airway pressure (CPAP) or weight reduction treatments on anxiety and depression. Background OSA is a life-threatening condition. Poor sleep quality, frequent arousals during sleep, and intermittent hypoxia that accompany patients with OSA could contribute to psychological disturbances. Patients and methods A total of 40 patients with OSA (19 males and 21 females) who were admitted to the Chest Department of Menoufia University Hospitals were included and divided into two groups based on different treatment: 20 patients were treated with CPAP and 20 patients were treated with weight reduction. Results There were no significant differences between both groups regarding age, sex, and BMI. The patients in both groups had high scores in Hamilton anxiety rating scale, Hamilton depression scale, and quality-of-life scale. CPAP and weight reduction treatment for 3 months resulted in significant improvements of anxiety and depressive symptoms. The Hamilton anxiety rating scale decreased from 11.7 ± 6.5 to 3.3 ± 1.8 in group 1 and from 9.6 ± 4.4 to 3 ± 2.1 in group 2, whereas the Hamilton depression scale score decreased from 16.5 ± 5.8 to 4.8 ± 2.1 in group 1 and from 17.5 ± 6.4 to 5.7 ± 2.6 in group 2 (both P<0.001). There were significant improvements in the quality of life in the two groups after 3 months of treatment. Conclusion Anxiety and depression are associated with OSA which improved after CPAP and weight reduction treatment.
{"title":"Anxiety and depression in patients with obstructive sleep apnea before and after treatment with continuous positive airway pressure","authors":"M. Zamzam, Rabab A. El-Wahsh, A. El-Abedin, Hend Bedir, Asmaa Abdel Tawab","doi":"10.4103/ecdt.ecdt_42_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_42_22","url":null,"abstract":"Aim To evaluate the prevalence of anxiety and depression in patients with obstructive sleep apnea (OSA) and effect of continuous positive airway pressure (CPAP) or weight reduction treatments on anxiety and depression. Background OSA is a life-threatening condition. Poor sleep quality, frequent arousals during sleep, and intermittent hypoxia that accompany patients with OSA could contribute to psychological disturbances. Patients and methods A total of 40 patients with OSA (19 males and 21 females) who were admitted to the Chest Department of Menoufia University Hospitals were included and divided into two groups based on different treatment: 20 patients were treated with CPAP and 20 patients were treated with weight reduction. Results There were no significant differences between both groups regarding age, sex, and BMI. The patients in both groups had high scores in Hamilton anxiety rating scale, Hamilton depression scale, and quality-of-life scale. CPAP and weight reduction treatment for 3 months resulted in significant improvements of anxiety and depressive symptoms. The Hamilton anxiety rating scale decreased from 11.7 ± 6.5 to 3.3 ± 1.8 in group 1 and from 9.6 ± 4.4 to 3 ± 2.1 in group 2, whereas the Hamilton depression scale score decreased from 16.5 ± 5.8 to 4.8 ± 2.1 in group 1 and from 17.5 ± 6.4 to 5.7 ± 2.6 in group 2 (both P<0.001). There were significant improvements in the quality of life in the two groups after 3 months of treatment. Conclusion Anxiety and depression are associated with OSA which improved after CPAP and weight reduction treatment.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"38 1","pages":"105 - 111"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81039429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samia Mohamed Rashad AbdelRehem, Ahmed Mahmoud Mohamed Galal, Mohammed Moustafa Metwaly
Abstract Background COVID-19 patients have encountered either central or peripheral nervous system affliction. However, there was no connection discovered between the COVID-19 very severe variant and neurological system disease, particularly neuropathy. Abnormalities in the biochemical markers of sepsis, neuroinflammation, and cytokine storm may be used to explain nervous system affection in COVID-19. Aim of the work This research aims to evaluate the relationship between the biochemical and radiological severity of COVID-19 and the peripheral neuropathy experienced by some COVID-19 patients. Patient and methods A comparative cross-sectional study was carried out on a sample of 175 adult patients who had positive COVID-19 PCR results. Patients were selected from records of those who have previously visited Ain Shams University hospitals with documented COVID-19 affection in the past two years (2020 and 2021). All patients underwent to baseline evaluations that include a complete medical history, a neurological examination, laboratory investigation, and a chest CT scan while being treated for acute COVID-19. Then nerve conduction study done for all patient have the inclusion criteria. Result Eighty-seven patients (50%) were female and 87 patients (50%) were male,with age range from 17 to 75 years (42.95 ± 12.12). The patient were divided to 4 groups according to COVID-19 affection, asymptomatic group 29 patient with 14 (48.3%) female and 15 (51.7%) male with age range from 20 to 63 year (43.1 ± 12.05), 49 patient mild COVID-19 with 30 (61.2%) female and 19 (38.8%) male with age 21–64 year (42.53 ± 11.31), 59 moderate COVID-19 with 26 female (44.1%) and 33 (55.9%) male with age range 23–75 year (44.51 ± 12.51), 37 severe COVID-19 with 17 female (45.9%), and 20 male (54.1%) with age 17–69 year (40.59 ± 12.71). There was no significant statistical difference between all groups regarding age ( P value 0.492) and sex ( P value 0.311) Regarding axonal peripheral neuropathy, there was 29 patient (100%) for asymptomatic group, 49 (100%) for the mild group, 55 (93.2%) for moderate group and 34 (91.9%) for the severe group having negative study and 0 (0%) for asymptomatic group, 0 (0%) for mild group, 4 (6.8%) for moderate group and 3 (8.1%) for severe groups having positive affection for axonal peripheral neuropathy with nonsignificant statistical difference between all groups( P value 0.110). For peripheral neuropathy there was 28 (96.6%) for asymptomatic group,44(89.8%) mild group, 50 (84.7%) moderate group and 26 (70.3%) severe group having negative study for peripheral neuropathy and 1 (3.4%) for asymptomatic group,5 (10.2%) mild group, 9 (15.3%) moderate group and 11 (29.7%) severe group having positive study for peripheral neuropathy with significant statistical difference between all groups( P value 0.017). Conclusion In our study, the peripheral neuropathy affection following COVID-19 infection was not statistically significant, with peripheral neu
{"title":"Assessment of peripheral neuropathy in post-COVID-19 patients and its relation to COVID-19 infection severity","authors":"Samia Mohamed Rashad AbdelRehem, Ahmed Mahmoud Mohamed Galal, Mohammed Moustafa Metwaly","doi":"10.4103/ecdt.ecdt_7_23","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_7_23","url":null,"abstract":"Abstract Background COVID-19 patients have encountered either central or peripheral nervous system affliction. However, there was no connection discovered between the COVID-19 very severe variant and neurological system disease, particularly neuropathy. Abnormalities in the biochemical markers of sepsis, neuroinflammation, and cytokine storm may be used to explain nervous system affection in COVID-19. Aim of the work This research aims to evaluate the relationship between the biochemical and radiological severity of COVID-19 and the peripheral neuropathy experienced by some COVID-19 patients. Patient and methods A comparative cross-sectional study was carried out on a sample of 175 adult patients who had positive COVID-19 PCR results. Patients were selected from records of those who have previously visited Ain Shams University hospitals with documented COVID-19 affection in the past two years (2020 and 2021). All patients underwent to baseline evaluations that include a complete medical history, a neurological examination, laboratory investigation, and a chest CT scan while being treated for acute COVID-19. Then nerve conduction study done for all patient have the inclusion criteria. Result Eighty-seven patients (50%) were female and 87 patients (50%) were male,with age range from 17 to 75 years (42.95 ± 12.12). The patient were divided to 4 groups according to COVID-19 affection, asymptomatic group 29 patient with 14 (48.3%) female and 15 (51.7%) male with age range from 20 to 63 year (43.1 ± 12.05), 49 patient mild COVID-19 with 30 (61.2%) female and 19 (38.8%) male with age 21–64 year (42.53 ± 11.31), 59 moderate COVID-19 with 26 female (44.1%) and 33 (55.9%) male with age range 23–75 year (44.51 ± 12.51), 37 severe COVID-19 with 17 female (45.9%), and 20 male (54.1%) with age 17–69 year (40.59 ± 12.71). There was no significant statistical difference between all groups regarding age ( P value 0.492) and sex ( P value 0.311) Regarding axonal peripheral neuropathy, there was 29 patient (100%) for asymptomatic group, 49 (100%) for the mild group, 55 (93.2%) for moderate group and 34 (91.9%) for the severe group having negative study and 0 (0%) for asymptomatic group, 0 (0%) for mild group, 4 (6.8%) for moderate group and 3 (8.1%) for severe groups having positive affection for axonal peripheral neuropathy with nonsignificant statistical difference between all groups( P value 0.110). For peripheral neuropathy there was 28 (96.6%) for asymptomatic group,44(89.8%) mild group, 50 (84.7%) moderate group and 26 (70.3%) severe group having negative study for peripheral neuropathy and 1 (3.4%) for asymptomatic group,5 (10.2%) mild group, 9 (15.3%) moderate group and 11 (29.7%) severe group having positive study for peripheral neuropathy with significant statistical difference between all groups( P value 0.017). Conclusion In our study, the peripheral neuropathy affection following COVID-19 infection was not statistically significant, with peripheral neu","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"145 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135667841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Menna-Allah Mohamed, Magdy Khalil, Haytham S. Diab, Ashraf El-Maraghy
Background Bedside lung ultrasound (US) is an essential tool in assessing lung aeration in severely ill patients. Aim The goal of this study was to determine the use of lung US in evaluating changes in lung aeration in dependent lung areas during positive end expiratory pressure (PEEP) titration in patients with acute respiratory distress syndrome (ARDS). Patients and methods A total of 52 mechanically ventilated patients with ARDS admitted in the ICU of Abbassia Chest Hospital were enrolled in this study. Transthoracic sonography was performed at the posterior axillary line on either side after 30 min of initial ventilator settings; recruitment at the end of expiration was sonographically assessed while changing PEEP. Arterial blood gases were performed before and after recruitment maneuver along with continuous monitoring of hemodynamics and oxygen saturation throughout the procedure. The procedure was terminated if the plateau pressure exceeded 30 cmH2O or if there was hemodynamic compromise. Results A total of 52 mechanically ventilated patients with ARDS were enrolled in the study. Overall, 80% had severe ARDS. Initial US assessments were done, and subpleural consolidation (C) was found in 18 patients, whereas exaggerated B lines (B) were found in 33 patients. After PEEP titration, under US guidance, 13 patients changed the US pattern from C to B and 22 patients changed from B to A (A-line pattern). These results correlated with improvement of PaO2/FiO2 ratio from 69.98 ± 27.93 to 86.21 ± 31.64 and increased compliance from 26.49 ± 8.63 to 28.73 ± 8.74. However, there was an increase in plateau pressure from 25.12 ± 3.88 to 27.98 ± 3.18, and also PaCO2 increased from 51.00 ± 16.05 to 58.52 ± 15.93. The mean arterial blood pressure decreased from 84.87 ± 7.91 to 81.60 ± 8.72. Conclusion US is an effective tool in achieving PEEP titration in mechanically ventilated patients with ARDS. US finding of aeration correlates well with improvement in oxygenation and compliance. However, the patients should be monitored for safe limits of pressures, hemodynamics, and PaCO2 level that may rise.
{"title":"Utility of lung ultrasound in adjustment of the initial mechanical ventilation settings in patients with acute respiratory distress syndrome","authors":"Menna-Allah Mohamed, Magdy Khalil, Haytham S. Diab, Ashraf El-Maraghy","doi":"10.4103/ecdt.ecdt_35_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_35_22","url":null,"abstract":"Background Bedside lung ultrasound (US) is an essential tool in assessing lung aeration in severely ill patients. Aim The goal of this study was to determine the use of lung US in evaluating changes in lung aeration in dependent lung areas during positive end expiratory pressure (PEEP) titration in patients with acute respiratory distress syndrome (ARDS). Patients and methods A total of 52 mechanically ventilated patients with ARDS admitted in the ICU of Abbassia Chest Hospital were enrolled in this study. Transthoracic sonography was performed at the posterior axillary line on either side after 30 min of initial ventilator settings; recruitment at the end of expiration was sonographically assessed while changing PEEP. Arterial blood gases were performed before and after recruitment maneuver along with continuous monitoring of hemodynamics and oxygen saturation throughout the procedure. The procedure was terminated if the plateau pressure exceeded 30 cmH2O or if there was hemodynamic compromise. Results A total of 52 mechanically ventilated patients with ARDS were enrolled in the study. Overall, 80% had severe ARDS. Initial US assessments were done, and subpleural consolidation (C) was found in 18 patients, whereas exaggerated B lines (B) were found in 33 patients. After PEEP titration, under US guidance, 13 patients changed the US pattern from C to B and 22 patients changed from B to A (A-line pattern). These results correlated with improvement of PaO2/FiO2 ratio from 69.98 ± 27.93 to 86.21 ± 31.64 and increased compliance from 26.49 ± 8.63 to 28.73 ± 8.74. However, there was an increase in plateau pressure from 25.12 ± 3.88 to 27.98 ± 3.18, and also PaCO2 increased from 51.00 ± 16.05 to 58.52 ± 15.93. The mean arterial blood pressure decreased from 84.87 ± 7.91 to 81.60 ± 8.72. Conclusion US is an effective tool in achieving PEEP titration in mechanically ventilated patients with ARDS. US finding of aeration correlates well with improvement in oxygenation and compliance. However, the patients should be monitored for safe limits of pressures, hemodynamics, and PaCO2 level that may rise.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"39 1","pages":"92 - 98"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73879099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The evaluation of coronavirus disease 2019 (COVID-19) patients with respiratory secondary bacterial infection, and the causative pathogens, is crucial for the treatment plan of those patients and to ensure the effective needed treatment with antibiotics and to decrease its abuse. Aim To clarify the incidence of bacterial infection in patients with COVID-19 and sensitivity to antibiotics. Patients and methods Samples of sputum were collected from 120 patients with confirmed COVID-19 by clinical, laboratory, radiological signs of pneumonia, or PCR, the severity of COVID-19 was classified as moderate and severe. The moderate type included patients with pneumonia without hypoxemia. The severe type was characterized by (a) dyspnea (respiratory rate ≥30/min), (b) blood oxygen saturation less than or equal to 93%, and (c) PaO2/FiO2 ratio less than 300 or lung infiltrates more than 50%. If one of the above items was met, it was classified as severe. Then, all cases were sent for screening of the presence of secondary bacterial infections by quantitative sputum bacterial culture and sensitivity. Positive cases of bacterial infection were classified into patients with early bacterial infection less than 15 days from COVID-19 infection and patients with late bacterial infections after more than 15 days of COVID-19 infection. Results In total, 40 (33.3%) cases out of 120 cases of COVID-19 showed bacterial growth, while 80 (66.7%) cases were negative for bacterial secondary infection. The most common organisms isolated were Klebsiella pneumoniae 12 cases, streptococci 10 cases, MERSA eight cases, Escherichia coli five cases and mixed infection by E. coli, Klebsiella, and Candida in five cases, Staphylococcus aureus was the same rate in early and late infections, all streptococci were early infection, and more cases of K. pneumoniae were late infection nine cases out of 13, where E. coli was early infection four cases out of five. All mixed infections were late. Conclusion Hidden secondary bacterial infection should be screened in COVID-19 patients. Early bacterial infections and moderate COVID-19 pneumonia are mainly caused by Gram-positive bacteria, but late bacterial infections and severe COVID-19 pneumonia are mainly caused by Gram-negative bacteria.
{"title":"Bacterial biogram in COVID-19 patients in Menoufia University isolation hospitals","authors":"G. Abdelaal, E. El-Masry, Sami Eldahdouh","doi":"10.4103/ecdt.ecdt_3_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_3_22","url":null,"abstract":"Background The evaluation of coronavirus disease 2019 (COVID-19) patients with respiratory secondary bacterial infection, and the causative pathogens, is crucial for the treatment plan of those patients and to ensure the effective needed treatment with antibiotics and to decrease its abuse. Aim To clarify the incidence of bacterial infection in patients with COVID-19 and sensitivity to antibiotics. Patients and methods Samples of sputum were collected from 120 patients with confirmed COVID-19 by clinical, laboratory, radiological signs of pneumonia, or PCR, the severity of COVID-19 was classified as moderate and severe. The moderate type included patients with pneumonia without hypoxemia. The severe type was characterized by (a) dyspnea (respiratory rate ≥30/min), (b) blood oxygen saturation less than or equal to 93%, and (c) PaO2/FiO2 ratio less than 300 or lung infiltrates more than 50%. If one of the above items was met, it was classified as severe. Then, all cases were sent for screening of the presence of secondary bacterial infections by quantitative sputum bacterial culture and sensitivity. Positive cases of bacterial infection were classified into patients with early bacterial infection less than 15 days from COVID-19 infection and patients with late bacterial infections after more than 15 days of COVID-19 infection. Results In total, 40 (33.3%) cases out of 120 cases of COVID-19 showed bacterial growth, while 80 (66.7%) cases were negative for bacterial secondary infection. The most common organisms isolated were Klebsiella pneumoniae 12 cases, streptococci 10 cases, MERSA eight cases, Escherichia coli five cases and mixed infection by E. coli, Klebsiella, and Candida in five cases, Staphylococcus aureus was the same rate in early and late infections, all streptococci were early infection, and more cases of K. pneumoniae were late infection nine cases out of 13, where E. coli was early infection four cases out of five. All mixed infections were late. Conclusion Hidden secondary bacterial infection should be screened in COVID-19 patients. Early bacterial infections and moderate COVID-19 pneumonia are mainly caused by Gram-positive bacteria, but late bacterial infections and severe COVID-19 pneumonia are mainly caused by Gram-negative bacteria.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"8 1","pages":"433 - 440"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78147680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Context Our study follows 34 patients during their home treatment after being diagnosed with moderate-severe coronavirus disease (COVID). The home treatment was chosen by the patients and their caregivers after being informed of the risks. Aim To evaluate the outcome of home treatment in patients with moderate to severe COVID who opted for home treatment instead of hospital admission. Patients and methods The retrospective study was conducted among patients diagnosed with SARS COV-2 with moderate to severe COVID who presented to our health care facility. We followed the patients from the initial diagnosis till the time of complete recovery. Results Overall, 87.5% of our moderate to severe COVID-infected patients were able to return to a full bill of health without the need for hospitalization. Age, BMI, or the presence of any comorbidity did not have a significant effect on the time till recovery or need for hospitalization in our sample. Majority of moderate to severe patients were not shown to need any hospitalization. Conclusion This sheds light on the fact that most moderate to severe COVID-infected patients may not require hospitalization and can be effectively managed at home under the supervision of a physician.
{"title":"Combating coronavirus disease 2019 at home: evaluation of home treatment approach for patients diagnosed with coronavirus disease 2019 with moderate and severe symptoms in Egypt","authors":"Mohamed Elbagalaty, S. Shawkat, Mohamed Mohamed","doi":"10.4103/ecdt.ecdt_34_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_34_22","url":null,"abstract":"Context Our study follows 34 patients during their home treatment after being diagnosed with moderate-severe coronavirus disease (COVID). The home treatment was chosen by the patients and their caregivers after being informed of the risks. Aim To evaluate the outcome of home treatment in patients with moderate to severe COVID who opted for home treatment instead of hospital admission. Patients and methods The retrospective study was conducted among patients diagnosed with SARS COV-2 with moderate to severe COVID who presented to our health care facility. We followed the patients from the initial diagnosis till the time of complete recovery. Results Overall, 87.5% of our moderate to severe COVID-infected patients were able to return to a full bill of health without the need for hospitalization. Age, BMI, or the presence of any comorbidity did not have a significant effect on the time till recovery or need for hospitalization in our sample. Majority of moderate to severe patients were not shown to need any hospitalization. Conclusion This sheds light on the fact that most moderate to severe COVID-infected patients may not require hospitalization and can be effectively managed at home under the supervision of a physician.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"32 1","pages":"452 - 456"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84892615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neeraj Kumar, D. Rai, Kiran Prem Raj, Subhash Kumar
{"title":"Coronavirus disease 2019 complicated by hemothorax, pneumomediastinum, pneumothorax, and subcutaneous emphysema: A rare association with literature review","authors":"Neeraj Kumar, D. Rai, Kiran Prem Raj, Subhash Kumar","doi":"10.4103/ecdt.ecdt_29_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_29_22","url":null,"abstract":"","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"34 1","pages":"542 - 546"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88045080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Pardeshi, T. Lokhande, Ashwini V. Shelke, T. Tuse, Bhagyshree Pawar, C. Bonde
The resistant to multidrug-resistant mycobacterium tuberculosis (MDR) strains has affected to the control on tuberculosis (TB). Drugs such as isoniazid and rifampin are commonly used for the therapy in TB. In these, in the phenomenon of the production of anti-TB drugs, the maintenance of the records is one of the challenging steps. The estimated global incidences of nearly half million are witnesses for MDR/rifampicin-resistant TB. This article included the global problem of the drug resistant to TB with its lengthy, complicated, and life-threatening effects with its poor results. Recently new medicines have been developed after a long time on the treatment of TB in MDR resistance. Levofloxacin, moxifloxacin, bedaquiline, delamanid, linezolid, and other second-line medications for TB treatment include levofloxacin, moxifloxacin, bedaquiline, delamanid, linezolid, and others. In the case of MDR-TB, a variety of medications are advised. In the treatment of TB, these medications are effective anti-TB drugs. The goal of this study is to analyze MDR-TB treatment methods in light of WHO guidelines for MDR-TB care in 2021.
{"title":"A breakthrough in the treatment of multidrug-resistant tuberculosis: A novel and effective approach","authors":"V. Pardeshi, T. Lokhande, Ashwini V. Shelke, T. Tuse, Bhagyshree Pawar, C. Bonde","doi":"10.4103/ecdt.ecdt_24_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_24_22","url":null,"abstract":"The resistant to multidrug-resistant mycobacterium tuberculosis (MDR) strains has affected to the control on tuberculosis (TB). Drugs such as isoniazid and rifampin are commonly used for the therapy in TB. In these, in the phenomenon of the production of anti-TB drugs, the maintenance of the records is one of the challenging steps. The estimated global incidences of nearly half million are witnesses for MDR/rifampicin-resistant TB. This article included the global problem of the drug resistant to TB with its lengthy, complicated, and life-threatening effects with its poor results. Recently new medicines have been developed after a long time on the treatment of TB in MDR resistance. Levofloxacin, moxifloxacin, bedaquiline, delamanid, linezolid, and other second-line medications for TB treatment include levofloxacin, moxifloxacin, bedaquiline, delamanid, linezolid, and others. In the case of MDR-TB, a variety of medications are advised. In the treatment of TB, these medications are effective anti-TB drugs. The goal of this study is to analyze MDR-TB treatment methods in light of WHO guidelines for MDR-TB care in 2021.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"54 1","pages":"413 - 423"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90759380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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